| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,244 |
2,237 |
$145K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,793 |
3,777 |
$127K |
| A4554 |
Disposable underpads, all sizes |
3,414 |
3,399 |
$112K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
1,562 |
1,550 |
$45K |
| A4927 |
Gloves, non-sterile, per 100 |
674 |
671 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$889.92 |